Cytoreductive surgery and intraperitoneal chemotherapy for colorectal peritoneal metastases

Table 3 Reported treatment-associated morbidity and mortality following multi-modality therapy for colorectal peritoneal metastase

Ref.	n	Mortality (%)	Overall morbidity (%)	No of bowel anastomoses	Intra-abdominal complications (%)	Extra-abdominal complications (%)
Portilla et al[33]	18	0	No treatment-associated morbidity data provided
Witkamp et al[34]	29	3	38	2 (0-5)	Postoperative bleeding (3)	Grade I-II leucopenia (21)
					Bowel perforation (3)	Grade III leucopenia (31)
					Bladder perforation (3)	Peripheral neuropathy (10)
					Return to theatre (17)	Subclavian vein thrombosis (3)
					Hydronephrosis requiring nephrostomy (7)
					Wound dehiscence (3)
					Prolonged chyle leak (3)
Pilati et al[35]	34	0	35	-	Non-specified complications: Ozols’grade I (53), grade II (9), grade III (1), grade IV (1)	Haematological toxicity (12)
						Pneumonia (12)
Verwaal et al[36]	106	-	No treatment-associated morbidity data provided
Glehen et al[37]	53	4	23	0.4 (0-4)	Return to theatre (4)	-
					Gastrointestinal fistula (8)
Mahteme et al[53]	18	0	61	-	Severe nausea and vomiting (12)	Transient neutropaenia (6)
					Leak from drain (6)
					Catheter-related problems (39)
Glehen et al[38]	506	4%	22.9	-	Re-operation (10.7)	Haematological toxicity (2.4)
					Fistula (8.3)	Systemic sepsis (2)
					Intra-abdominal abscess (1.8)	Cardiorespiratory complications (3.5)
					Urinary fistula (1)
Shen et al[39]	77	12	30	-	Bowel perforation (3)	Haematological toxicity (19)
Cavaliere et al[40]	120	3.3	22.5	-	Perforation (5)
					Anastomotic leak (3.3)
					Infection (3.3)
Kianmanesh et al[41]	43	2.3	39	-	Deep abscess (14)	Pleural effusion (12)
					Intestinal fistula (9)	Renal failure (7)
					Delayed gastric emptying (9)	Superficial wound infection (12)
					Re-operation (4)
Gusani et al[42]	28	0	56.5	-	Re-operation (8)	Systemic sepsis (4)
					Anastomotic leak (8)
					Intra-abdomoninal abscess (4)
					Wound dehiscence (4)
					Enterocutaneous fistula (2)
Verwaal et al[26]	54	-	No treatment-associated morbidity data provided
Yan[17]	50	0	46	-	Small bowel obstruction (12)	Pleural effusion (34)
					Fistula (10)	Pneumonia (4)
					Intra-abdominal abscess (10)
					Perforation (4)
Elias et al[54]	48	-	No treatment-associated morbidity data provided
Varban et al[43]	142	CPM with HM	CPM with HM	-	CPM with HM	CPM with HM
		7.1%	57.1%		Bowel leak (11)	Pneumonia (7)
		CPM with no HM	CPM with no HM		Wound infection (11)	Neutropaenia (7)
		7.7%	40.1%		Pancreatic fistula (11)	DVT (7)
					Ileus (11)	CPM with no HM
					CPM with no HM	Pneumonia (6)
					Bowel leak (5)	Neutropaenia (8)
					Wound infection (5)	AF (3)
					Ileus (5)	Thrombocytopaenia (2)
					Enterocutaneous fistula (1)
Vaira et al[44]	40	2.5	55	0 (17.5)	Fistula (10)	Haematological toxicity (12.5)
				1(55)	Abdominal abscess (7.5)	Pleural effusion (22.5)
				2 (27.5)		Superficial wound infection (12.5)
Glehen et al[45]	523	-	Not specifically provided for patients undergoing procedures for CPM
Franko et al[55]	105	-	No treatment-associated morbidity data provided
Quenet et al[46]	146	4.1	47.2	-	GI fistula (4.8)	-
					Urinary fistula (1.4)
					Abdominal abscess (2.7)
					Reoperation (11.6)
Cashin et al[57]	32	HIPEC group;	HIPEC group;	-	HIPEC group;	HIPEC group;
		6%	37%		Reoperation (12)	CVA (6)
		EPIC group;	EPIC group;		EPIC group;	EPIC group;
		6%	19%		Reoperation (6)	-
Passot et al[47]	120	3.8	21.8	-	Reoperation (13.3)
					Fistula (7.5)
Hompes et al[48]	48	0	52.1	1 (0-6)	Prolonged ileus (23)	Pulmonary (12.5)
					Anastomotic leakage (10.4)	Cardiac (2.1)
					Bleeding (6.3)	Urological (12.5)
					Bowel perforation (2.1)	Haematological (2.5)
					Fistula (2.1)
					Abscess (2.1)
					Reoperation (20.8)
Cashin et al[56]	151	HIPEC group:	HIPEC group:	-	-	-
		4%	41%
		EPIC group:	EPIC group:
		3%	30%
Klaver et al[49]	24	0	62	-	Prolonged ileus (21)	Superficial wound infection (4)
					Intra-abdominal collection requiring drainage (21)	Cardiorespiratory complications (38)
					Fistula (4)	Urological (4)
					Splenic infarction (4)
Turrini et al[50]	26	0	33	-	Fistula (10)	Haematological toxicity (10)
					Delayed gastric emptying (10)
Haslinger et al[51]	38	-	Not specifically provided for patients undergoing procedures for CPM
Yonemura et al[52]	142	0.7	42.9	-	-	-

CPM: Colorectal peritoneal metastase; HM: Hepatic metastasis; HIPEC: Hyperthermic intraperitoneal chemotherapy; EPIC: Early post-operative intraperitoneal chemotherapy.